Basic Information
Provider Information
NPI: 1952716748
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHHABRA
FirstName: SHEENU
MiddleName:  
NamePrefix:  
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Credential: MD
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Mailing Information
Address1: 3170 KETTERING BLVD
Address2: BUILDING B, 3RD FLOOR
City: MORAINE
State: OH
PostalCode: 454391924
CountryCode: US
TelephoneNumber: 9379913188
FaxNumber: 9372239811
Practice Location
Address1: 30 E APPLE ST STE NW3300
Address2:  
City: DAYTON
State: OH
PostalCode: 454092939
CountryCode: US
TelephoneNumber: 9372088394
FaxNumber: 9372088388
Other Information
ProviderEnumerationDate: 06/30/2014
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMT205790PAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X35130072OHY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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